دورية أكاديمية
أعرض في EDS

Taurolidine and Heparin as Catheter Lock Solution for Central Venous Catheters in Hemodialysis.

التفاصيل البيبلوغرافية
العنوان: Taurolidine and Heparin as Catheter Lock Solution for Central Venous Catheters in Hemodialysis.
المؤلفون: Nguyen T; Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY., Camins BC; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; and., Butler DA; Department of Pharmacy Practice, Albany College of Pharmacy & Health Sciences, Albany, NY.
المصدر: American journal of therapeutics [Am J Ther] 2024 Jul-Aug 01; Vol. 31 (4), pp. e398-e409. Date of Electronic Publication: 2024 May 07.
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9441347 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1536-3686 (Electronic) Linking ISSN: 10752765 NLM ISO Abbreviation: Am J Ther Subsets: MEDLINE
أسماء مطبوعة: Publication: 1998- : Philadelphia, PA : Lippincott Williams & Wilkins
Original Publication: New York, NY : Chapman & Hall, c1994-
مواضيع طبية MeSH: Taurine*/analogs & derivatives , Taurine*/pharmacology , Taurine*/administration & dosage , Heparin*/administration & dosage , Heparin*/pharmacology , Renal Dialysis*/instrumentation , Renal Dialysis*/methods , Renal Dialysis*/adverse effects , Thiadiazines*/pharmacology , Thiadiazines*/administration & dosage , Central Venous Catheters*/adverse effects , Catheter-Related Infections*/prevention & control , Anticoagulants*/administration & dosage , Anticoagulants*/pharmacology, Humans ; Catheterization, Central Venous/adverse effects ; Randomized Controlled Trials as Topic ; Kidney Failure, Chronic/therapy ; Anti-Infective Agents, Local/administration & dosage ; Anti-Infective Agents, Local/pharmacology
مستخلص: Background: Chronic kidney disease can lead to end-stage renal disease, and the prevalence is increasing. Many patients starting hemodialysis require central venous catheters (CVCs). Catheter-related bloodstream infections (CRBSIs) are a common complication and lead to significant morbidity and mortality. Interventions to prevent CRBSI include antimicrobial lock therapy but concern for the development of antimicrobial resistance and adverse effects. Nonantimicrobial antiseptics as catheter lock solutions have also been used. Taurolidine and heparin catheter lock solution is first approved by the Food and Drug Administration for the prevention of CRBSI in patients on hemodialysis. Taurolidine has a unique mechanism of action and favorable safety profile.
Mechanism of Action, Pharmacodynamics, and Pharmacokinetics: Taurolidine and heparin catheter lock solution have both antimicrobial and anticoagulant properties. Taurolidine is derivative of the amino acid taurine, and heparin is derived from porcine intestinal mucosa. Taurolidine not only damages microbial cell walls but also prevents the adherence of microorganisms to biological surfaces, preventing biofilm formation. Taurolidine and heparin catheter lock solution is intended to be used intraluminally within the catheter and should be aspirated. Because it is used locally, limited pharmacokinetic and pharmacodynamic data are available.
Clinical Trials: The LOCK-IT-100 trial is a randomized, double-blind, phase 3 study, which included 795 end-stage renal disease patients on hemodialysis with CVC. Taurolidine and heparin was compared with the control heparin alone. The results of the study showed a 71% risk reduction in CRBSI for taurolidine and heparin arm (95% confident interval, 38%-86%, P = 0.0006). Other studies have also shown that taurolidine lock solution leads to decreased CRBSI episodes. Several systematic reviews and meta-analysis consisted of taurolidine in adult, and pediatric populations also showed reduction in the incidence of CRBSIs.
Therapeutic Advance: Taurolidine and heparin lock solution represents a novel preventive strategy for those undergoing hemodialysis through a CVC by reducing the risk of CRBSI. This is significant progress because there are no other similar options available for patients for whom catheters are the only options for their life-saving treatment.
Competing Interests: T. Nguyen: no conflict of interest. B. C. Camins: Advisor for Applied UV, Inc and Premier, Inc. D. A. Butler is currently receiving a grant (#23020) from CorMedix, Inc.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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المشرفين على المادة: 1EQV5MLY3D (Taurine)
8OBZ1M4V3V (taurolidine)
9005-49-6 (Heparin)
0 (Thiadiazines)
0 (Anticoagulants)
0 (Anti-Infective Agents, Local)
تواريخ الأحداث: Date Created: 20240506 Date Completed: 20240708 Latest Revision: 20240709
رمز التحديث: 20240710
DOI: 10.1097/MJT.0000000000001736
PMID: 38710029
قاعدة البيانات: MEDLINE
الوصف
تدمد:1536-3686
DOI:10.1097/MJT.0000000000001736